Epidemiological characteristics and diagnostic approach in patients admitted to the emergency room for transient loos of consciousness: Group for Syncope Study in the Emergency Room (GESINUR) study

Aims: To assess the clinical presentation and acute management of patients with transient loss of consciousness (T-LOC) in the emergency department (ED). Methods and results: A multi-centre prospective observational study was carried out in 19 Spanish hospitals over 1 month. The patients included were 14 years old and were admitted to the ED because of an episode of T-LOC. Questionnaires and corresponding electrocardiograms (ECGs) were reviewed by a Steering Committee (SC) to unify diagnostic criteria, evaluate adherence to guidelines, and diagnose correctly the ECGs. We included 1419 patients (prevalence, 1.14%).ECG was performed in 1335 patients (94%) in the ED: 498 (37.3%) ECGs were classified as abnormal. The positive diagnostic yield ranged from 0% for the chest X-ray to 12% for the orthostatic test. In the ED, 1217 (86%) patients received a final diagnosis of syncope, whereas the remaining 202 (14%) were diagnosed of non-syncopal transient lossof consciousness (NST-LOC). After final review by the SC, 1080 patients (76%) were diagnosed of syncope, whereas 339 (24%) were diagnosed of NST-LOC (P , 0.001). Syncope was diagnosed correctly in 84% of patients. Only 25% of patients with T-LOC were admitted to hospitals. Conclusion Adherence to clinical guidelines for syncope management was low; many diagnostic tests were performed with low diagnostic yield. Important differences were observed between syncope diagnoses at the ED and by SC decision.

New diagnostic and therapeutic approaches to treat ventricular tachycardias originating at the summit of the left ventricle role of merged hemodynamic-MRI and alternative ablation sources

The left ventricular (LV) summit is the most common site of idiopathic epicardial LV arrhythmias and frequently represents a diagnostic and a therapeutic challenge.1 We present a case of sustained monomorphic ventricular tachycardia (SMVT) originating at the LV summit that underwent failed cryosurgical epicardial ablation and was successfully treated with the aid of merged hemodynamic and contrast-enhanced MRI (CE-MRI).

Drifting plasma collection by a positive biased tether wire in LEO-like plasma conditions: current measurement and plasma diagnostic

BETs is a three-year project financed by the Space Program of the European Commission, aimed at developing an efficient deorbit system that could be carried on board any future satellite launched into Low Earth Orbit (LEO). The operational system involves a conductive tape-tether left bare to establish anodic contact with the ambient plasma as a giant Langmuir probe. As a part of this project, we are carrying out both numerical and experimental approaches to estimate the collected current by the positive part of the tether. This paper deals with experimental measurements performed in the IONospheric Atmosphere Simulator (JONAS) plasma chamber of the Onera-Space Environment Department. The JONAS facility is a 9- m3 vacuum chamber equipped with a plasma source providing drifting plasma simulating LEO conditions in terms of density and temperature. A thin metallic cylinder, simulating the tether, is set inside the chamber and polarized up to 1000 V. The Earth's magnetic field is neutralized inside the chamber. In a first time, tether collected current versus tether polarization is measured for different plasma source energies and densities. In complement, several types of Langmuir probes are used at the same location to allow the extraction of both ion densities and electron parameters by computer modeling (classical Langmuir probe characteristics are not accurate enough in the present situation). These two measurements permit estimation of the discrepancies between the theoretical collection laws, orbital motion limited law in particular, and the experimental data in LEO-like conditions without magnetic fields. In a second time, the spatial variations and the time evolutions of the plasma properties around the tether are investigated. Spherical and emissive Langmuir probes are also used for a more extensive characterization of the plasma in space and time dependent analysis. Results show the ion depletion because of the wake effect and the accumulation of- ions upstream of the tether. In some regimes (at large positive potential), oscillations are observed on the tether collected current and on Langmuir probe collected current in specific sites.

Advanced data acquisition system implementation for the ITER Neutron Diagnostic use case using EPICS and FlexRIO technology on a PXIe platform

In the framework of the ITER Control Breakdown Structure (CBS), Plant System Instrumentation & Control (I&C) defines the hardware and software required to control one or more plant systems [1]. For diagnostics, most of the complex Plant System I&C are to be delivered by ITER Domestic Agencies (DAs). As an example for the DAs, ITER Organization (IO) has developed several use cases for diagnostics Plant System I&C that fully comply with guidelines presented in the Plant Control Design Handbook (PCDH) [2]. One such use case is for neutron diagnostics, specifically the Fission Chamber (FC), which is responsible for delivering time-resolved measurements of neutron source strength and fusion power to aid in assessing the functional performance of ITER [3]. ITER will deploy four Fission Chamber units, each consisting of three individual FC detectors. Two of these detectors contain Uranium 235 for Neutron detection, while a third "dummy" detector will provide gamma and noise detection. The neutron flux from each MFC is measured by the three methods: . Counting Mode: measures the number of individual pulses and their location in the record. Pulse parameters (threshold and width) are user configurable. . Campbelling Mode (Mean Square Voltage): measures the RMS deviation in signal amplitude from its average value. .Current Mode: integrates the signal amplitude over the measurement period

Design and integration of lower ports for ITER diagnostic systems

All around the ITER vacuum vessel, forty-four ports will provide access to the vacuum vessel for remotehandling operations, diagnostic systems, heating, and vacuum systems: 18 upper ports, 17 equatorialports, and 9 lower ports. Among the lower ports, three of them will be used for the remote handlinginstallation of the ITER divertor. Once the divertor is in place, these ports will host various diagnosticsystems mounted in the so-called diagnostic racks. The diagnostic racks must allow the support andcooling of the diagnostics, extraction of the required diagnostic signals, and providing access and main-tainability while minimizing the leakage of radiation toward the back of the port where the humans areallowed to enter. A fully integrated inner rack, carrying the near plasma diagnostic components, will bean stainless steel structure, 4.2 m long, with a maximum weight of 10 t. This structure brings water forcooling and baking at maximum temperature of 240?C and provides connection with gas, vacuum andelectric services. Additional racks (placed away from plasma and not requiring cooling) may be requiredfor the support of some particular diagnostic components. The diagnostics racks and its associated exvessel structures, which are in its conceptual design phase, are being designed to survive the lifetimeof ITER of 20 years. This paper presents the current state of development including interfaces, diagnos-tic integration, operation and maintenance, shielding requirements, remote handling, loads cases anddiscussion of the main challenges coming from the severe environment and engineering requirements.